There appears to be "significant evidence" the Copeman Healthcare Centre is contravening the Canada Health Act, Dosanjh wrote in a Jan. 26 letter to the health minister.

The clinic charges an initial $3,900 fee, followed by annual payments of $2,900, Dosanjh wrote. The money "allows payees to receive preferred access to medically necessary treatment," giving them priority access to insured services, he said.

He cited a 2006 legal opinion prepared for the Ontario Health Coalition that found Copeman's billing system raised "very substantial and serious issues" with regards to the Canada Health Act.

The B.C. Health Coalition, which has raised questions about Copeman's billing practices over the past several years, said it "has received numerous complaints from members of the public who have been denied insured medical services because they are unable to pay the thousands of dollars in additional fees charged by the Copeman Centres."

The BCHC release quoted Nora Etches from Canadian Doctors for Medicare saying Copeman clinics poach family doctors and other professionals from communities. "Charging large block fees and linking medically unnecessary services to necessary ones undermines Medicare," she said.

Health Canada promised in October to investigate Sentinelle Health Group and the Quebec government is looking into Medisys 123 and other clinics, the release said.

The B.C. government audited Copeman's clinic in 2007 and found no evidence the billing practices broke the law, the Tyee reported. The BCHC argued that the government didn't look at the key question of whether people who did not pay the fees were denied care.

Andrew MacLeod is The Tyee’s Legislative Bureau Chief in Victoria. Reach him here.